BRYANT STREET FAMILY MEDICINE P.C. NPI 1396909446

NPI Information

NPI: 1396909446
Provider Name: BRYANT STREET FAMILY MEDICINE, P.C.
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 37D1085354

Address:
305 SOUTH BRYANT AVE
110
EDMOND, OK
ZIP 73034
Phone: (405) 513-7333
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BRYANT STREET FAMILY MEDICINE, P.C. is a primary care clinic center in Edmond, OK. BRYANT STREET FAMILY MEDICINE, P.C. NPI is 1396909446. The provider is registered as an organization entity type.

The provider's business location address is:

305 SOUTH BRYANT AVE
110
EDMOND, OK
ZIP 73034
Phone: (405) 513-7333
Fax: (405) 513-7337

The provider's authorized official is Chesca Nicole Craig-goodell .
The authorized official title is Physician and has the following contact phone number (405) 513-7333.

The CLIA number assigned to this NPI record is 37D1085354 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/17/2008 and was last updated on 11/1/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care		OKLAHOMA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1366510802	OTHER	OKLAHOMA	INDIVIDUAL PROVIDER NPI NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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